1. Teaching Aids: NNFNBH- 1 Newborn Health Challenge in India 26 million births / year –Account for 20% of Global births 1.2 million die in neonatal period –Account for about 30% of Global deaths Deaths - Global Vs India India accounts for highest births & neonatal deaths

2. Teaching Aids: NNFNBH- 2 Neonatal mortality rate (NMR) Current - 44/1000 live births Accounts for almost 2/3 rd of IMR & ½ of U5-MR Nearly 3/4 th of neonatal deaths occur within 7 days, most during first 48 hours

3. Teaching Aids: NNFNBH- 3 NMR - State wise 10 in Kerala 60 in Orissa, M.P. U.P., M.P, Bihar together contribute to nearly 50% of neonatal deaths in India (about 15% of the global burden)

4. Teaching Aids: NNFNBH- 4 Perinatal indices Still birth rate: 30-35 per 1000 births Perinatal mortality rate: 60-70 per 1000 births Approx. 0.8 million still births & 1.7 million perinatal deaths annually

5. Teaching Aids: NNFNBH- 5 Place of birth 2/3 rd of deliveries at home Only 42% attended by skilled birth attendants* Higher the institutional births, lower is the NMR 60 11-15M.P/ Bihar 10 95Kerala NMR Inst. births (%) State * doctors, nurses, and midwives

6. Teaching Aids: NNFNBH- 6 Causes of Neonatal Death Neonatal sepsis (includes pneumonia) Birth asphyxia Prematurity Tetanus declined ‘1980-90’ Source: Bang AT et al, Lancet 1999

7. Teaching Aids: NNFNBH- 7 Decline of NMR Rapid decline in the eighties –69 in 1980 –53 in 1990 Stagnation since the nineties –48 in 1995 –44 in 2000

8. Teaching Aids: NNFNBH- 8 Why static NMR?  Govt. programmes focused to post neonatal periods - Diarrhoeal Disease Control - Diarrhoeal Disease Control - ARI - Immunization  Focus of essential newborn component was on a limited number of government facilities  Lack of skilled persons for managing newborn

9. Teaching Aids: NNFNBH- 9 Way forward Importance to newborn health Earlier initiatives CSSM, RCH-I RCH – II (2005-10) - IMNCI: Community & facility - IMNCI: Community & facility - Promotion of institutional deliveries - Promotion of institutional deliveries -Strengthening of health facilities -Strengthening of health facilities

10. Teaching Aids: NNFNBH- 10 National Goals Current 10 th five yr plan 2007 NPP 2010 MDG Targets 2015 IMR6445<3727 NMR4426<20<20 MMR407200<100100 Hospital births 34%80%80% NPP: National Population Policy; MDG: Millennium Development Goals